Month: August 2025

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Until Death Do Us Part

Caregiving at Home with Love and Faith

Robert n Angela Happy Birthday
Robert and Angela’s final birthday celebration a couple of weeks before sepsis ended Robert’s care at home.

Saint Patrick’s Day 2021 was the 40th anniversary of our first meeting. Robert called me from the bedroom, but romance was not on his mind. Rather he announced not being able to get up from the floor and implored me to bring him the urinal or he’ll pee on the carpet. I grumbled. But providentially my morning devotion had taken me to Jeremiah 32:17:

‘Oh, Lord God! Behold, You Yourself have made the heavens and the earth by Your great power and by Your outstretched arm! Nothing is too difficult for You . . . (New American Standard Bible)

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Clearly with God’s help I could easily do this for Robert. So why was I annoyed? It was more about him forgetting to bring the urinal to the bedroom than not mentioning the anniversary. Plus, I knew how hard it would be getting him up from the floor, again.

In the next three years, at least eleven 9-1-1 calls brought Emergency Medical Technicians (EMTs) to the house to pick up Robert after a fall and sometimes take him to the ER to check for injuries. Occasionally Robert called 911 or used his medic alert button without telling me. The first I knew was when an EMT tapped on the bedroom window in the middle of the night calling my name, or I walked into the lounge to find several EMTs attending to him.

In an effort to reduce the need for emergency calls, we trialed a power chairlift hoping I could use it to get Robert off the floor. Unfortunately, it wasn’t safe for either of us and we never identified another one that would work. However, we did add bed rails to impede falls and lowered his bed to minimize injury should he still fall out of bed.

In 2021 and 2022, Robert’s main medical issues were high blood pressure (BP), weakness, and bladder spasms. All three were treatable—BP with medication and weight loss, weakness with physical therapy (PT), and spasms with medication and botox surgeries. However, Robert had an issue with portion control; typically only did PT exercises when the therapist was present; and botox had a negligible effect.

Since diet and exercise are both a matter of the will, Robert’s failure to cooperate was a constant source of frustration to me. Consequently, I became the nagging wife searching for ways to motivate him to stay away from the fridge, swim, walk, or do his therapy homework. Usually it was wasted breath. Only when I gave up and brought the matter to God in prayer did anything change. For example, on the morning of May 10, 2021, I was convicted by Psalm 66:18-19 (New Living Translation):

If I had not confessed the sin in my heart,
the Lord would not have listened.
But God did listen!
He paid attention to my prayer.

And in the afternoon, I was blown away when Robert initiated doing a set of exercises!

By the time of our 40th American wedding anniversary in November 2021, love was still in the air. I gave Robert a Hallmark card with these words:

I believe we were meant to work through hard times and learn to overcome and stay strong.
I believe we were meant to love each other, to laugh together, to get better as the days go by.

Robert soon reciprocated with an original Valentine card:

They say love is patient and kind and I know that’s true because of you.
I’ve felt the true comfort of knowing you’re there through thick and thin—even when life’s crazy or I fall short of my best.
I’m a lucky husband and a better man for having you at my side and for having your love in my life.

Indeed I had many opportunities to show my love and grow my patience as the hard times multiplied and intensified:

  • In January 2022, Robert stopped driving due to difficulty getting in and out of his minivan, slow reaction times, and memory issues.
  • In February 2022, Robert developed lower limb weakness due to chronically irritated nerves in his lower back.
  • In March 2022, Robert was diagnosed with mild cognitive impairment.
  • Ongoing bladder issues involved spasms and sudden urges necessitated medication, use of a urinal and absorbent bed pads and underwear.
  • In August 2022, breathing difficulties required ongoing nebulizer treatments.
  • Kidney Disease was diagnosed at Chronic Stage III in August 2022; Severe Stage IV in October 2023, and End Stage V in March 2024.
  • Robert slept a lot and lost his sense of day and night. For example, he called me at 3:00 AM asking for a drink of water.
  • In September 2024 and thereafter, multiple infections stemmed from his urinary tract and dialysis catheter; sepsis stripped him of all but one-or-two words and he totally depended on the scooter for mobility. He needed more care than I could provide at home!

Despite my caregiver role increasing as Robert’s condition decreased, we still strived to preserve as much independence as possible. When he was unable to get onto the regular height toilet, we replaced it with a kindergarten height. When a bottom wiping aid was inadequate, we installed a bidet toilet seat. When this wasn’t enough, I needed extra steel to finish the job manually.

I transported Robert to all appointments—doctor, dentist, lawyer, barber et al.—and sporadic outings to restaurants; visit family; repair hearing aids; and attend high value events like a nieces wedding and a 50th high school reunion. We gave up on LPA weekend trips after having major issues accessing hotel beds and toilets. Church only happened on his good days.

Robert top pics
Robert bottom pics

After the End-Stage Renal Disease diagnosis, preparation for outings took at least two hours for a bed bath; transfer to the scooter; dressing; eating; toileting; and rounding up his glasses, hearing aids, and wallet. Extra time was built in to allow for a final bathroom stop, boarding Hugo—our Wheelchair Accessible Van—and tying down the scooter he was sitting in.

Managing the renal diet and medication were also on my plate. The primary focus was on sodium, potassium, and phosphorus. Limiting how much salt Robert ate was easy because salt was already off our menu. Because dialysis can’t remove much potassium and phosphorus from the blood, levels are best controlled by not eating food with these ingredients in the first place. I relied on renal diet education materials for shopping and monthly blood work results to see when it was safe to eat a small portion of otherwise forbidden food, like bananas, chocolate, potatoes, or nuts. Robert savored the one piece of dark chocolate a day approved by the dialysis center dietitian.

My hardest duties were the ones previously in Robert’s domain—hiring contractors and purchasing or repairing equipment. My first response to the leaking pool pump was to ignore it. Bad idea. It got worse and the pool cleaning guy kept pressuring me to buy a new pump. But through prayer and help from friends and family, I tracked down the manufacturer and he sent me a replacement part for free. I also found the guy who originally installed the timer for the lawn sprinkler which now needed replacing. Thankfully, I knew enough about mobility scooters to troubleshoot whether to repair or replace them when they conked out.

On November 28, 2023—our last wedding anniversary at home—I wrote this message to Robert:

Now as we walk through our bonus years (in our 70s) may we continue to love God and one another. Our future is in His Hands; let us continue to depend on and draw from God’s power and love as we encounter frustration and the infirmities of aging.

And God was faithful to the end.

For details on issues mentioned in this post, you may also want to read other blog posts by Angela Muir Van Etten:

For more information on kidney nutrition, go to: